Casewell M W, Dalton M T, Webster M, Phillips I
Lancet. 1977 Aug 27;2(8035):444-6. doi: 10.1016/s0140-6736(77)90621-3.
A gentamicin-resistant strain of Klebsiella aerogenes was isolated from the urine of 17 patients out of 237 admitted to a male urological ward between Jan. 21 and May 9, 1977. The factors most frequently associated with K. aerogenes in the urine were catheterisation and antibiotic therapy. Often the epidemic strain (type K16) was found not only in the patients' faeces but also on more remote skin sites such as hands, knees, groins, and the umbilicus. Resistance to gentamicin and many other antibiotics was R-factor mediated. Barrier nursing of colonised patients, stringent staff handwashing with chlorhexidine, and the use of disposable aprons seemed to contain the outbreak. Hand carriage was demonstrated in one nurse 62 days after she had left the ward.
1977年1月21日至5月9日期间,在一所男性泌尿外科病房收治的237名患者中,有17人的尿液中分离出了一株对庆大霉素耐药的产气克雷伯菌。尿液中产气克雷伯菌最常相关的因素是导尿和抗生素治疗。通常,流行菌株(K16型)不仅在患者粪便中发现,而且在手部、膝盖、腹股沟和脐部等更远端的皮肤部位也能发现。对庆大霉素和许多其他抗生素的耐药性是由R因子介导的。对定植患者实施屏障护理、工作人员严格用洗必泰洗手以及使用一次性围裙似乎控制住了疫情。一名护士离开病房62天后,其手部仍检测出携带病菌。